Psychological interventions may be effective for non-cardiac chest pain

Clinical question: 
How effective are psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy?
Bottom line: 
Psychological treatments, especially cognitive behavioural therapy and hypnotherapy, may be effective in terms of reduced chest pain frequency in the short term (up to 3 months) for the treatment of non-specific chest pain. The evidence for brief interventions was less clear. No adverse effects of psychotherapy were found.
Caveat: 
The benefits of treatment were not sustained beyond 3 months. There was no effect on the severity of the chest pain. The evidence was limited to small trials of questionable quality.
Context: 
Recurrent chest pain in the absence of coronary artery disease is a common, difficult-to-treat problem that can lead to excess use of medical care. A substantial number of patients are not reassured by negative medical assessment, reporting persistent pain and limitations. Psychological factors appear to be of importance for treatment.
Review CD#: 
CD004101
PEARLS No: 
368
Date: 
September, 2012
Authored by: 
Brian R McAvoy